How HRV Wearables Can Help Track Mental Health and Relapse Risk During Addiction Recovery

Can heart rate variability help clinicians better understand—and eventually anticipate—the challenges people face during recovery from substance use disorder?

In this episode of the Heart Rate Variability Podcast, host Matt Bennett speaks with Dr. J. Gregory Hobelmann, Dr. Wendy Insalaco, and Dr. Andrew Huhn about their research on physiological and mental health changes during residential substance-use disorder treatment.

Their study paired wearable measurements of heart rate variability (HRV) and resting heart rate with self-reported assessments of stress, anxiety, and depression. Although participants generally demonstrated favorable changes during treatment, their individual trajectories varied widely. For some people, physiological and self-reported improvements aligned; for others, the two told different stories.

The conversation explores why this variability matters, how objective biomarkers may complement—not replace—traditional clinical assessments, and how wearable data could eventually support more individualized care, timely check-ins, and relapse-prevention efforts.

Topics discussed include:

• What a typical 28-day residential treatment experience involves

• Why substance-use treatment outcomes have traditionally relied heavily on self-report

• How WHOOP wearables were used to monitor HRV and resting heart rate

• The relationship between HRV, stress, anxiety, and depression

• Why physiological recovery and perceived wellness do not always move together

• State-versus-trait differences in anxiety and autonomic functioning

• The importance of sleep and healthy cortisol patterns during recovery

• Using biometric changes as prompts for supportive clinical conversations

• The risks of overconfidence and overreliance on wearable data

• The potential for personalized treatment plans and just-in-time interventions

• How academic and residential-treatment partnerships can advance precision medicine

About the guests:

Dr. J. Gregory Hobelmann, MD, MPH, is an addiction psychiatrist and Co-CEO and President of Ashley Addiction Treatment in Havre de Grace, Maryland.

Wendy Insalaco, PhD, LCADC, LCPC, is an addiction psychologist and researcher who serves as Director of Quality Outcomes and Model of Care at Ashley Addiction Treatment.

Andrew S. Huhn, MBA, PhD, is an Associate Professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. His research examines opioid use disorder, relapse risk, sleep, stress, mood, wearable technology, and treatment outcomes.

Resources:

Read the study:
https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2026.1755153/full

Learn about Ashley Addiction Treatment:
https://www.ashleytreatment.org/

Learn more about Dr. Andrew Huhn:
https://profiles.hopkinsmedicine.org/provider/andrew-stephen-huhn/2777487

Explore Optimal HRV:
https://www.optimalhrv.com/

The Heart Rate Variability Podcast is produced by Optimal LLC and Optimal HRV.

This podcast is provided for informational purposes only and is not medical advice. Consult a qualified healthcare professional before applying any strategies discussed in this episode.